Biomedical subjects

Teresa L Panniers

Publications and source records attributed to Teresa L Panniers.

4 recordsLinked to original sources

PubMed2006

Methods in informatics: Development of a multiattribute utility questionnaire for feeding decisions in the neonatal intensive care unit.

Evidence that guides practice is gleaned from objective data and from the inherent value set of the decision maker. This study depicts the construction and initial testing of a multiattribute utility (MAUT) instrument for discerning feeding choices of neonatal nurse practitioners (NNPs) for the clinical problem of choosing between early enteral feeds and late enteral feeds for premature infants in a neonatal intensive care unit. Based on an individual's preferences, a decision may vary from that recommended by the objective data in the literature yet may represent a choice that is internally consistent with individual knowledge and values. Deconstructing and evaluating decisions using a method such as the MAUT can provide valuable information to support the development phase of decision support applications in the field of informatics.

Decision Support Systems, Clinical↗

PubMedDate not supplied

Methods in informatics: using data derived from a systematic review of health care texts to develop a concept map for use in the neonatal intensive care setting.

A qualitative systematic review of textbooks and clinical guidelines identified assessment criteria for initiation of nipple feeds in premature infants cared for in the neonatal intensive care unit (NICU) setting. Using a structured method for text source selection and data extraction, 43 health care texts were systematically reviewed yielding 153 separate statements related to assessing premature infants' feeding readiness. Following this procedure, a pile sort method was conducted wherein an expert neonatal nurse practitioner (NNP) grouped the statements according to similarity in meaning. Ten piles of terms emerged from this process. Each pile was "named," depicting discrete components used when assessing premature infants' readiness for nipple feeding. Using these public data and the private knowledge of the NNP informant, a concept map was constructed to illustrate a framework for decision support development and to examine the map's usefulness for structuring knowledge that will provide input to an intelligent decision support system.

Computational Biology↗

PubMedDate not supplied

Building an expert system: a systematic approach to developing an instrument for data extraction from the literature.

When building an expert system that will be acceptable to clinicians in their practice, it is imperative that the knowledge engineer identifies, defines, and describes a clinical problem precisely. This can be accomplished by eliciting private knowledge from expert clinicians or by analyzing public knowledge available in the scientific literature. This study describes a systematic method for examining public knowledge found in health care textbooks and practice guidelines surrounding the concept of oral feeding in premature infants in a neonatal intensive care unit. It includes the development of an instrument for extracting data from these sources to standardize definitions of terminologies. Preliminary results and plans for further analysis are reported. This method can be applied to other clinical problems deemed appropriate for decision support system development.

Decision Making, Computer-Assisted↗

PubMedDate not supplied

Refining clinical terminology for expert system development: an application in the neonatal intensive care unit.

PURPOSE: To clarify terms surrounding the clinical problem of initiating oral feeding in premature infants cared for in the neonatal intensive care unit (NICU). Understanding terminology at the outset of expert system (ES) development forms the crucial foundation needed to build a system that is accurate, relevant, and useful for assisting clinicians. METHOD: Ethnographic methods were used. In phase 1 participant observation with an interdisciplinary neonatology team was used to study oral feeding for premature infants. In phase 2 in-depth interviews were conducted with a neonatal nurse practitioner (NNP) to explore feeding terms and the description and understanding of these terms. FINDINGS: Results showed that oral feeding was a complex term that encompassed several feeding options; specifically nipple, breast, gavage, and transpyloric feeding. CONCLUSIONS: Each of the terms had a specific meaning within the context of the NICU.

Expert Systems↗